Anesthesia & Analgesia,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Nov. 21, 2024
Preoperative
biofluid
biomarkers
reflecting
pathophysiological,
neuronal
injury,
and
inflammation
as
well
those
for
Alzheimer's
disease
(AD)
may
be
valuable
tools
the
risk
stratification
of
perioperative
neurocognitive
disorders
(PNDs)
in
older
adults.
We
summarized
current
evidence
relating
these
preoperative
to
PND
beyond
7
days,
surgical
participants
aged
≥60
years.
Studies
that
evaluated
association
with
cognitive
decline
an
outcome,
were
identified
through
searches
6
databases
3
trial
registries
17
January
2024.
Preclinical
studies,
intracranial
surgical,
or
studies
<60
years
excluded.
varied
widely
assessment
PND,
so
a
wide
range
outcomes
was
accepted,
including
using
term
postoperative
dysfunction
(POCD)
define
decline.
The
pooled
incidence
POCD
utilizing
binary
outcome
summarized.
Fifteen
involving
2103
included.
Marked
heterogeneity
evident
metrics,
timeframes,
limiting
quantitative
synthesis.
Of
9
binarized
outcomes,
23.4%
(95%
confidence
interval
[CI],
6.6-46.2)
at
<3
months,
11.4%
CI,
8.1-15.0)
<12
6.9%
1.9-14.5)
≥12
months
postoperatively.
15
described
blood-based
biomarkers,
4
cerebrospinal
fluid
(CSF)
2
measured
both
blood
CSF
markers.
reflected
pathogenic
indicators
injury
(9
studies),
(5
studies)
amyloid
Tau
(1
study).
included
medium
high
quality.
Evidence
most
promising
5
demonstrating
associations
lower
biomarker
levels
increased
POCD.
In
conclusion,
hold
potential
utility
prediction
POCD,
although
remains
limited.
Other
p-Tau181
Neurofilament
Light,
however
small
sample
sizes,
study
heterogeneity,
conflicting
results
limited
conclusions
drawn.
Standardized
metrics
common
timeframes
are
additionally
required
future
ascertain
prognostic
Neuroreport,
Journal Year:
2025,
Volume and Issue:
36(6), P. 297 - 305
Published: March 26, 2025
To
investigate
the
effects
of
resveratrol
(RES)
on
cognitive
function
and
its
modulation
NRF2/HO-1
signaling
pathway
in
a
rodent
model
postoperative
dysfunction
(POCD).
A
POCD
was
established
aged
Sprague–Dawley
rats
using
sevoflurane
anesthesia
laparotomy.
Rats
were
divided
into
four
groups:
control,
POCD,
RES,
+
RES.
Cognitive
performance
assessed
Morris
water
maze.
Hippocampal
tissues
analyzed
for
neuronal
condition
hematoxylin
eosin
Nissl
staining.
The
expression
levels
inflammatory
cytokines
oxidative
stress
markers
quantified
by
enzyme-linked
immunosorbent
assay.
messenger
RNA
protein
NRF2,
KEAP1,
HO-1,
SOD2
measured
real-time
quantitative
polymerase
chain
reaction
western
blotting.
RES
treatment
improved
function,
as
evidenced
reduced
escape
latency
increased
platform
crossings
Histopathological
analysis
showed
restoration
hippocampal
structure
viability.
significantly
proinflammatory
interleukin
(IL)-1
IL-6
while
increasing
IL-10
levels.
In
addition,
activated
upregulating
downregulating
KEAP1.
mitigates
deficits
reducing
neuroinflammation
through
activation
pathway.
These
findings
suggest
is
potential
therapeutic
candidate
elderly
patients.
Deleted Journal,
Journal Year:
2025,
Volume and Issue:
10(1)
Published: March 31, 2025
Context:
Post-operative
cognitive
dysfunction
(POCD)
and
postoperative
delirium
(POD)
are
common
complications
following
major
surgery,
particularly
in
older
adults.
Emerging
evidence
suggests
that
olfactory
may
significantly
predispose
individuals
to
these
disturbances,
potentially
serving
as
an
early
marker
for
post-surgical
decline.
However,
the
relationship
between
impairment
post-operative
outcomes
remains
underexplored.
Objectives:
The
present
systematic
review
aims
synthesize
current
on
impact
of
POCD
POD.
Evidence
Acquisition:
adhered
preferred
reporting
items
reviews
meta-analyses
(PRISMA)
guidelines.
A
comprehensive
search
PubMed,
Scopus,
Web
Science
(WOS)
was
conducted
from
inception
until
December
2024.
Studies
patients
undergoing
operations
involved
verified
examinations
yielded
quantitative
data
were
included.
Exclusion
criteria
encompassed
research
focusing
non-surgical
groups,
non-original
studies,
studies
lacking
assessments.
Results:
From
initial
389
articles,
seven
met
inclusion
criteria,
comprising
1,038
participants.
These
2004
2022,
included
surgeries
such
cardiac,
abdominal,
neurosurgery.
Various
tests
[e.g.,
sniffin’
sticks,
brief
smell
identification
test
(BSIT)]
assessments
mini-mental
state
examination
(MMSE),
clock
drawing
(CDT)]
used.
findings
across
heterogeneous
but
suggested
a
potential
link
both
Specifically,
several
indicated
impaired
function
associated
with
increased
risk
(OR
=
1.90;
95%
CI
1.17
-
3.09)
decline
post-surgery.
Some
identified
independent
predictor
worse
outcomes,
among
frail
or
elderly
populations.
Conclusions:
reviewed
supports
hypothesis
be
preoperative
POCD,
delayed
neurocognitive
recovery
(dNCR).
Based
obtained
results,
testing
could
useful
screening
tool,
especially
populations
at
Cellular and Molecular Neurobiology,
Journal Year:
2025,
Volume and Issue:
45(1)
Published: April 21, 2025
Post-operative
cognitive
decline
(POCD)
is
characterized
by
impairments
in
functions.
Coronary
artery
bypass
grafting
(CABG)
associated
with
a
high
risk
of
POCD
due
to
its
impact
on
neuroinflammation
and
oxidative
stress.
In
this
study,
we
investigated
the
dynamics
neurotrophic,
inflammatory,
stress
markers
cohort
post-CABG
patients
identify
potential
biomarkers
for
POCD.
Blood
samples
were
collected
at
baseline
(immediately
post-surgery)
3-month
follow-up.
Expression
levels
NRF2
other
regulators
(GST,
GSS,
HMOX1,
CAT,
HSP27,
LOX-1),
inflammatory
mediators
(IL-6,
IP-10,
NFκB),
neuroprotective
factor
(BDNF)
analyzed.
Cognitive
assessments
performed
using
RBANS,
TMT,
TIB
MMSE.
exhibited
an
initial
upregulation
NRF2-related
antioxidant
genes,
which
failed
sustain
3-months
follow-up,
leading
IP-10
BDNF
protein
levels,
along
increased
LOX-1
level
NFκB
expression,
indicating
persistent
inflammation.
contrast,
non-POCD
demonstrated
sustained
increase
markers,
suggesting
more
effective
compensatory
response.
ROC
analysis
identified
HMOX1
as
significant
predictors
POCD,
emerging
diagnostic
conclusion,
our
findings
highlight
dynamic
regulation
pathways
emphasizing
failure
neuroprotection
affected
patients.
Further
large-scale
studies
are
necessary
validate
these
findings,
biomarker-based
screening
could
facilitate
early
stratification
targeted
interventions
improve
outcomes
after
cardiac
surgery.
Frontiers in Pharmacology,
Journal Year:
2025,
Volume and Issue:
16
Published: April 28, 2025
Background
Remimazolam,
a
novel
ultra-short-acting
benzodiazepine,
is
potential
sedative
for
non-general
anesthesia
surgery
in
the
elderly.
This
study
aimed
to
investigate
appropriate
dosage
of
remimazolam
and
its
effects
on
perioperative
cognitive
function
elderly
patients
undergoing
surgery.
Methods
multicenter,
placebo-controlled
trial
enrolled
330
procedures
at
eight
centers
China
from
July
2021
February
2022,
with
238
ultimately
completing
study.
The
primary
endpoints
were
dose
successful
sedation
changes
function.
Adverse
events
recorded
assess
drug
safety.
Results
induction
spinal
was
5.38
mg
(95%
confidence
interval
[CI],
5.20–5.56),
maintained
rate
0.223
mg·kg
−1
·h
CI,
0.201–0.237)
no
serious
adverse
effects.
Compared
standard
saline
group,
there
statistical
difference
MMSE
scores
Day
2
morning
(P
=
0.886),
afternoon
0.864),
7
0.613),
MoCA
0.687),
0.827),
0.483)
group.
Conclusion
Remimazolam
besylate
an
effective
neuraxial
anesthesia.
It
successfully
induced
,
demonstrating
good
safety
profile
without
affecting
short-term
postoperative
Clinical
Trial
Registration
http://www.chictr.org.cn
(ChiCTR2100048744).
Cureus,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Sept. 2, 2024
Postoperative
delirium
(POD)
and
neurocognitive
disorders
(NCDs)
are
common
serious
complications
that
can
occur
after
surgery,
particularly
in
older
adults
those
with
preexisting
cognitive
impairments.
These
conditions
associated
significant
morbidity,
increased
healthcare
costs,
reduced
quality
of
life.
Understanding
the
underlying
mechanisms,
risk
factors,
effective
management
strategies
for
POD
NCDs
is
critical
improving
patient
outcomes
reducing
burden
on
systems.
This
comprehensive
review
aims
to
synthesize
current
knowledge
pathophysiology,
NCDs.
It
explores
neurobiological
molecular
mechanisms
contributing
these
conditions,
identifies
patient-related,
surgical,
environmental
factors
increase
risk,
evaluates
pharmacological
non-pharmacological
approaches
prevention
treatment.
A
thorough
literature
was
conducted
using
recent
studies,
clinical
guidelines,
expert
consensus
provide
a
detailed
overview
presentation,
prevention,
The
pathophysiology
involves
complex
interactions
between
neuroinflammatory
processes,
neurotransmitter
imbalances,
brain
network
disruptions.
Risk
include
advanced
age,
impairment,
type
duration
perioperative
complications.
Management
emphasize
multidisciplinary
approach,
incorporating
preoperative
optimization,
careful
intraoperative
management,
postoperative
interventions.
Pharmacological
treatments,
such
as
antipsychotics,
approaches,
including
modifications
rehabilitation,
play
crucial
roles
management.
multifactorial
impacts
surgical
outcomes.
Effective
requires
understanding
their
implementation
targeted
treatment
strategies.
Future
research
should
focus
personalized
treatment,
further
elucidation
developing
predictive
models
enhance
care
patients
at
